LGBT Mental Health: Are We Doing Enough?

The results of a five-year-long study have found that 48 percent of young trans people had attempted suicide and that 34 percent of young LGB people had made at least one suicide attempt in their lives.

Ayden Keenan-Olson, who took his own life when he was 14. His mother says he suffered homophobic abuse and believes that the school didn't do enough to stop it. Screenshot via Channel 4 News

Dan was 14 when he took knives upstairs to kill himself. As a kid in an orthodox Jewish family, where being gay was an abomination, he was so depressed that he felt like he was in a cave. Alone in the house, he stared at the sharp blades, not knowing how to start.

Suddenly a voice sounded: "Is anybody home?" It was his mum's friend. The moment passed. Today, he rarely thinks about that night. "It was really painful being gay as a kid," says Dan. "To the extent that I buried it so far in my mind because it was horrible psychologically. There are many things that I've never spoken about, and I'm very lucky to have got through it."

"[Lesbian, gay, bisexual and transgender] mental health is a real and significant problem," says Matthew Todd, editor of Attitude, whose forthcoming book Straight Jacket deals with the subject. "Society treats everyone from birth as if they are heterosexual. If you're not heterosexual and/or cisgendered [where your gender aligns with the sex you are assigned at birth] then there is huge pressure to suppress that part of yourself.

"The most significant time is when we are growing up. We get it from our parents, from school, from religions, from government, historically; from media, from every film you see and every book you read. The world is not as safe for LGBT people as it is for straight people."

This assumed straightness of everyone is also known as "heteronormativity". If you need an example, take advertising, where the vast majority of couples depicted are made up of one smiling man and one smiling woman. "I was very lucky to live in Berlin for a bit," says Dan, now a confident 31-year-old man. "When you're on the tubes you see many more adverts that depict gay couples. It's a daily sense of belonging and affirmation." When travel company Expedia launched an advert in London recently that featured a gay couple, responses on social media ranged from the positive and non-fussed to users claiming it was "repulsive", that it had left them "puking violently". There was also plenty of the enduringly-original, "I hate faggots."

The RaRE report, a five-year-long study commissioned by LGBT mental health charity Pace, found that 34 percent of young LGB people (under 26) surveyed had made at least one suicide attempt in their lives. Forty-eight percent of young trans people had attempted suicide. This is compared to 18 percent of heterosexual and 26 percent of cisgender young people. Major causes were identified as homophobic or transphobic bullying and "struggles about being LGB or trans within the family [and] at school".

In 1988, a piece of legislation named Section 28 was introduced into British schools, implemented by Margaret Thatcher. Simultaneously vague and all-encompassing, it forbade "the promotion of homosexuality". Teachers across the country were terrified to mention the word "gay", or even tackle homophobic bullying, lest they lose their jobs.

Although Section 28 was repealed in 2003 by the Labour government, its fumes still roam about the pipes of our antiquated education system, thick enough to smother most sense of belonging for LGBT youth.

"We need to talk more about sexual diversity. More normality," says Callum Berry, 18, who left school ten months ago. "I definitely encountered homophobia between the ages of 11 and 15, before I had even fully accepted that I was gay. I've suffered from periods of intense OCD, and became obsessed with the idea of having a normal 'straight' life, so I went through a period of self-harm and anxiety, becoming very nervous every time I saw a man I was attracted to."

A five-year-long study commissioned by LGBT mental health charity Pace found that 34 percent of young LGB people surveyed had made at least one suicide attempt in their lives. Forty-eight percent of young trans people had attempted suicide.

The RaRE report found that 57.1 percent of LGB and 85.2 percent of trans young people have self-harmed at least once. Callum says the acceptance he had from his family was crucial to getting through this period, as well as "seeing and meeting their friends who were happy being gay".

Mind is the biggest mental health charity in the UK, and they acknowledge that the scars left by isolation of LGBT youth can lash well into adulthood. "There is still a lack of local services that meet the needs of LGBT people," says Geoff Heyes, Policy and Campaigns Manager. "Mind wants access and availability of mental health services to be truly person-centred, and for commissioners of services to understand the importance of offering genuinely inclusive and LGBT-affirmative support."

Lydia Cawson, a 29-year-old gay woman, is currently training to become a mental health practitioner. Part of the reason is because she doesn't believe there is enough accessible help for people of the LGBT community.

"I suffered a great deal with mental health," she says. "I never received any help for discussing my sexuality, gender and personal identity because these factors were masked by other health concerns. I was anorexic between the ages of 16 and 21 and was constantly being told that it was my rejection of femininity and womanhood. I was challenged to find that connection and 'get better'. There was no consideration that that was part of the problem."

The RaRE report states how many gay and bisexual women use alcohol to "manage uncomfortable or unwanted feelings... in relation to concerns around same-sex attraction". Of those surveyed, 37.1 percent of LGB women were found to have engaged in hazardous drinking. The causes involved, again, were adolescent experience and linking of sexuality to feared reactions of coming out, as well as using alcohol as a crutch to deal with heteronormative family expectations.

This rationale may partially explain the recent rise of "chemsex" among gay men, where mephedrone, GHB (gamma-Hydroxybutyric acid) and crystal meth are used during sex. Monty Moncrieff is Chief Executive of London Friend, which runs the LGBT substance abuse service Antidote. "There definitely appears to be a link between drugs becoming a problem and people struggling with their [LGBT] identity and esteem," he says. "One thing a lot of guys tell us is that what they really want is more emotional intimacy in their sexual relationships." As chemsex expert David Stuart says, if you stymie your intimacy in adolescence, hiding away your sex in shame, it can be hard to find intimacy in later life in actual sex.

The idea of gay sex is still a taboo idea for so many. The gay-shaming attitudes of some (presumably straight) men towards gay sex could be evidenced recently when VICE posted Photos from the UK's Biggest Gay Porn Awards on Facebook. In the comments, about 50 guys tagged their friends as having won awards. I asked Dr Qazi Rahman from the Institute of Psychiatry at King's College London if he had any insight into this type of humour that could very easily be labelled as gay-shaming.

"It's a way of boosting social status among heterosexual male friendship networks and self-esteem by exalting the in-group (fellow heterosexuals) through holding particular kinds of prejudice," he tells me. "The human tendency to form out-groups and in-groups is part of our coalitional psychology, but it is also malleable and so can change. This is why gay-straight alliances in schools are a good idea because they promote a newer kind of 'coalition' between LGBT and straight students."

Gay-straight alliances are fairly thin on the ground in mainstream culture. On TV, we don't seem to have moved on from the perennial-outfit-judger-carrying-the-shopping-bags for Carrie in Sex and the City template. It's rare to see a straight guy with a gay best friend on any screen. Socially, too, the LGBT "scene" is – with some noteworthy exceptions – largely segregated. Some might like it that way, but the us-and-them thing produces its own unhealthy mentalities.

The gay male scene, as I have experienced myself, is filled with visions of largely unrealistic male bodily perfection. "It's control," says Damien Killeen, a 25-year-old actor and Soho bartender. "You have control of your body, even though you don't have control over anything else. So if people are going to look at you and think you're disgusting for what you do sexually, at least they can be slightly jealous of the fact you look fucking great. It's hard to see how we're going to break out of it as a society and as a community – we're so obsessed with it."

According to the RaRE report, 59.2 percent of gay and bisexual men are unhappy with their body shape, compared with 40 percent of heterosexual men. Feelings of low self-esteem due to society's masculine ideal, combined with homophobic bullying at school around their physical appearance, were identified as common causes.

But low self-esteem has a physical health implication, too: sexually transmitted infections. For if you don't value yourself as a person, why would you protect yourself against HIV?

Adrian Hyyrylainen-Trett is running for Liberal Democrat MP of Vauxhall. He recently revealed himself as HIV positive in a frank interview with Patrick Strudwick. "I am 100 percent convinced that the homophobic bullying I received in my teens led me to become so self-destructive and end up deliberately wanting to annihilate myself," he tells me.

An HIV positive diagnosis can, in many cases, bring further mental health problems for LGBT people. "Mental health and HIV are often linked," says Eleanor Briggs, Assistant Director of Policy and Campaigns at the National AIDS Trust. "Research suggests depression is twice as common among people living with HIV as the general population. Sometimes self-stigma and blame can make people feel worthless – which can be made worse by internalised homophobia." Then you have the likes of Nigel Farage and Richard Littlejohn blasting their foghorns on the subject like two tinpot pantomime villains, spouting their ignorance at anyone who'll listen.

"I am 100 percent convinced that the homophobic bullying I received in my teens led me to become so self-destructive and end up deliberately wanting to annihilate myself" – Adrian Hyyrylainen-Trett, Liberal Democrat PPC for Vauxhall

This is all only the tip of the LGBT mental health iceberg, but we could try to chip it down. As the RaRE report states, full training and LGBT awareness is essential for healthcare professionals – and you can understand why. I've personally heard a 21-year-old gay man under section claim to be suffering discrimination from heavily religious nursing staff.

Hyyrylainen-Trett is pretty definitive on how we begin untangling the twisted strings at this problem's heart: same-sex sex education.

"If there were proper, open sex and relationships education in all schools – discussion of different families and LGBT role models in Britain in the 21st century – then I am certain that children would be more aware of differences, and people wouldn't stand by and allow bullying," he says. This aligns with the campaign to introduce same-sex SRE education, which was further bolstered recently in a call from the National Union of Teachers to discuss sexuality and gender.

Last week, Labour announced their LGBT manifesto, "A Better Future for Britain's LGBT Community", in which the party promises to "transform access to mental health services for LGBT next generation". In the same week, an inquest has heard that transgendered woman Mikki Nicholson committed suicide last November after being taunted in the street. Her community psychiatric nurse Clive Guyo said: "She described Carlisle [where she lived] as hostile to people who are different."

If hate stems from a fear of difference, then understanding is our first step to eradicating fear. James Taylor, Head of Policy at Stonewall, says: "Our ambition is for a world where every single LGBT person can experience acceptance without exception." Moral development has not reached its climax with the modern age. In the future, historians will hopefully look back at our culture as brave enough to make all its members feel that they belong.

Dan is thankful he never used those knives that night. That wasn't the case for Ayden Keenan-Olson, who overdosed at the same age that Glass contemplated suicide – 14 – after being bullied for being gay. This isn't happening to "LGBT youth", it's happening to our youth, full stop. If we leave things as they are – if we don't address society's lingering stigmas at a formative level – then none of us, gay or straight, can lay a finger on the notion of pride.